Healthcare Provider Details

I. General information

NPI: 1528128030
Provider Name (Legal Business Name): WUDBHAV NOTT SANKAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 MARKET ST FL 7
PHILADELPHIA PA
19104-5545
US

IV. Provider business mailing address

3737 MARKET ST FL 7
PHILADELPHIA PA
19104-5545
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-3340
  • Fax:
Mailing address:
  • Phone: 215-662-3340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number25MA08527400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberMD425644
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: